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I turned my paperwork in the night of the lap band seminar and today (4 weeks later) got a call to set up my bariatric appt with the dietician, nurse, & Pshyciatrist. My appt is next week and I just wondered how soon did most people have their surgery after this step. I realize this may be totally different for each person, but it is becoming so surreal now, and I just want to get some ideas. Thanks!!!:smile:

I know this topic has come up a gazillion times, but here we go again. I met with my surgeon last week, and he gave me the option of doing either surgery. I had assumed RnY because I occasionally have mild reflux and I'm quite large (BMI > 50). The doctor said my reflux is so mild, that it doesn't preclude sleeve surgery. I don't have diabetes, or any of the standard comorbidities that would typically push someone towards RnY. For me, advantages of sleeve are being able to use NSAIDs if needed, maintaining my pyloric valve, no surgery on my intestines, lower complication rate, less malabsorption. Advantages of RnY: greater average weight loss in first year (though it seems to even out by year 3 according to my reading), potential negative reinforcement of eating sweets (dumping syndrome). The Vitamin protocols for both are the same with my program, and our bariatrics specialist says that the risk of malnutrition is very low if you are compliant with Vitamins (<3% for compliant folks, while they typically see closer to 15% of patients with issues). Take your vitamins, folks! For me, it comes down to am I willing to take a higher risk of complications for the possibility of greater weight loss? I'm in this to be healthy and active, not skinny or attractive. It's a tough call to make. Especially when the end result, what happens 3, 5, 15 years down the line, all comes down to how I use the tool that I am given. What were the key things that you thought about when making your choice?

I know this is a long shot but I am looking for anyone in the Appleton, WI area that has had surgery or thinking about it. I have been told that the two surgeons here know their stuff. I did go to a meeting to meet them but of course they are always going to put out the best of themselves......lol.

Hi @@qmissy824 i, like you, am also just starting my journey. My appointment is 8/2 I'm in Florida. I'm looking forward to starting the process and seeing what the bariatric surgeon says. Keep me posted on your appointment. Hopefully we will both be on the same timeline. Are you going through insurance? Sent from my iPhone using the BariatricPal App

Perky Jerky gives you free samples. go to their website, click contact us. Fill out the form and mark the drop down for bariatric surgery. Then just ask them, they mail them in a couple of weeks.

The best Protein,hands-down, are from the Inspire line from Bariatric Eating. Online orders are backed up right now, but they are worth the wait. Your body has more than enough calories stored--you don't need to worry about that. Of primary concern is hydration, and it seems as though you have that covered well. Of secondary concern are nutrients---and you will build up to getting those in. For now, it really is important to find a protein source you can tolerate, and which is within your surgeon's guidelines. As for Vitamin, I'd suggest a good-quality bariatric vitamin--there are Vitamins made specifically to meet the needs of those who are banded. Some are chewable, and others are capsules. I can't tolerate pressed tablets/pills, but have no trouble with capsules, because they dissolve before moving through the stoma.

Take a very deep breath and decide if you are truly ready for this to happen. If you are, none of the other stuff should matter at all. Take things one step, one day at a time and that is how it all becomes less overwhelming. This includes the 3 week diet. It really is not that bad and will kick start your weight loss, ensure you have a healthier liver and make things safer. I can tell you that every bit of this is worth it in the end. I am 14 months post op, down 135lbs and 10 lbs from my goal. I thank god everyday for putting the Bariatric community on this earth to help us get healthy. When you feel the stress practice breathing very deep, it can be calming. Good luck to you!

How is everyone doing that have December dates? My date is Dec 17th, I will be having my gallbladder out also. I am nervous as to be expected. I also had to have a stress test on friday--that was gruelling. And I have to have an echocardiogram tomorrow morning. I have to get "cardiac clearance" before they can operate, since my EKG came back "abnormal". I had to go visit a friend in the hospital where I amhaving surgery and she was right where my surgery will be in the pre-op room! So I got to see how it will all go down! It was kinda scary but I left thinking "hey, I can do this!" I was at 250 when I first when to the Bariatric Center, now I am at 239(or maybe less now) So I am doing everything I am supposed to. Just have to get comfortable instead of all of these nerves. Blessing and much luck to all of the Holiday Hotties out there! Next year we WILL be Holiday Hotties fighting off those men(or women) with a stick! :biggrin:

Well I'm in Sacramento, and this is the area that Kaiser refers their patients to the area mentioned in another thread. Also, my Mom works for Kaiser (which is why they were my provider growing up) so I'm asking her to get some insider info or brocures on their bariatric department. That will probably help alot. I will contact my Personnel Dept to find out all my health care options to help with my decision. It doesn't sound like my health providers cover this surgery though. I know Blue Shield that I have doesn't (which really stinks!!)

Thanks to those who responded kindly and respectfully. I should have been more clear: I was not looking for medical advice here, but rather to know if different plans allowed different things. The bariatric community seems to be a large one and there are always differences in plans. My question was if this was one where everyone agreed or were there some of you out there who had a different approach given by your doctors before approaching my dr/nut with my question. Obviously I'd never dream of harming myself by not following medical orders. But reading these responses I see there is no point in even giving them a call, bec there seems to be a unanimous approach to this in the greater community. Thanks, all.

I would suggest reading everything you can, so you can make an informed decision. Obesityhelp.com describes all the different procedure, including Lapband, and there is a book called The Lapband Solution, and another called The Lapband Companion. Both books are available on Amazon.com and are full of information. You don't give up real food forever. Check your insurance first and see if it is covered. Some insurances (mine is Blue Choice) require one 6 month or two 3 month documented dietary weight loss attempts before they will approve you. Mine did and I spent the 6 months going to support groups (you meet people at all stages of pre and post op--good place to learn) buying sampler packs of chewable Vitamins and Calcium (both are required after surgery, as well as B12), and reading online. I have been coming here since November. My insurance criteria for surgery is BMI 40 or more (you can calculate this on obesityhelp.com) and 100 pounds overweight, or BMI 35-39 with one or more co-morbidities (diabetes, high blood pressure, high cholesterol, joint arthritis, sleep apnea, reflux). My BMI was 37-38 and I have everything on the list except diabetes. Most Bariatric groups require an informational seminar after which you have no obligation, but if you choose to have surgery the seminar is required as a first step. If you choose to continue, you will have a consultation with the surgeon, a psych evaluation, and once surgery is approved, a dietary consult on pre and post op food restrictions. I used the dietician for my 6 month diet as well. Different doctors do different things with pre-op diets. Some want a few days, some a few weeks, some a specific diet product, they are all different. My surgeon, if he thinks you may have a fatty liver, will put you on a full liquid diet for two weeks prior to surgery to shrink the liver, and somewhat to jump start your weight loss. I was on it for 3 weeks (I caught a cold and my surgery was postponed a week--not enough time to go off and back on, so I stayed an extra week--lost 25 more pounds after losing 10 on my 6 month diet). After surgery most people do liquids for 2 weeks, then "mushies" or pureed foods for 2 weeks, then solid food. My liquid diet included Protein drinks, milk, juice(diluted 50% with water), fat/sugar free Jello, fa/sugar free popsicles, broths, cream Soups, tea, coffee. The pureed stage I had applesauce, refried Beans, instant mashed potatoes, creamy egg or tuna salad, anything the consistency of apple sauce. Solid foods are a bit trial and error. Some foods will agree with you, others may not. For me bread gets too chewy and sits like a lump, but I can eat croutons on a salad. pizza (I love pizza) dough doesn't agree so much, so I invented a crustless pizza (sauce, turkey pepperoni, peppers, onions, fat free Kraft mozarella in a microwavable disk; heat for a couple minutes and you have the toppings without the dough). I did the same with meatballs (turkey meatballs, spaghetti sauce, parmesan cheese,heat in microwave--either meatball sub without the roll or spaghetti without the noodles). They told us not to have rice and Pasta for a while, but I don't think it is forever. I checked with the dietician and then went to a church spaghetti dinner. I cut up my spaghetti and meatballs like you would for a kid, ate the salad, passed on the roll and dessert. And for drinking, you wait about a half hour to eat after drinking, do not drink with meals, and wait 45 minutes to an hour after a meal to drink. So yes, the way you eat will change, and some of the things you eat will change. The amount of whatever you eat will definitely change, but it is worth it. I have lost an additional 35 lbs since surgery and gone down two clothing sizes for work (I wear scrubs--down from 2x to large). I am hoping also to reduce or eliminate some of the meds I am on. Sorry to run on but there is a lot to know. Check your insurance, talk to your PCP, go to the seminar and support groups, and then decide if this is the way you want to go.

2010 is just a few weeks old and yet things are off to a great start. I actually look forward to getting exercise and trying new forms of exercise. I can go into GNC now and not feel like a fish out of water. I am taking care of myself and striving to be the healthiest version of myself that I can be. I have determined that this year I am going to complete projects that I had started long ago. I now have a renewed energy that kept me from seeing things through. I hate to admit it but I have neglected so many things because I was always tired or sluggish. I am going to paint my kitchen, finish some quilting projects, maybe even plant a small garden(if winter ever decides to end) I find that I'm no longer content to sit down and just read all weekend. I want to see my goals achieved. If I can repeat myself just one more time ..... I am so very happy with my decision to have this surgery and I am going to encourage others to do the same. It truly IS life-changing!!!!

I used to take a B12 once a month and I didn't notice any type of apetite change or energy boost when I received my injection. I have heard of some people having this kind of reaction but I personally didn't. I think it just depends on the person. It makes sense with an energy boost, apetite changes would occur since it's feasable a metabolic change could occur as well. Perhaps you sould consider a sublingual to prevent a sudden dose of B12 and a metabolic change? I use Vita4Life sublinguals, and since finding them I haven't required the shots at all. The link is here. Good luck! http://vita4life.net/products/bariatric-vitamins-b-12-sublingual.html

Yes google Bariatric ocs..in you're area or better yet call you're insurance!!!

I have GHI as well and it was a 6 month supervised diet (it would have been 3 months if I was able to use a bariatric center for the monitoring which mine didnt have available) Hope you figured it all out...the insurance requirements are a bit much but we must follow them....ugh! My surgery date is set for 9/19...will be starting preop diet 9/4...if you ever want to chat message me!

Since finding out about, and deciding VSG was the right surgery for me back in August I knew that I would have to wait until after the 1st of the year to really get the ball rolling on the surgery due to finances. I initially decided on a doc, but the program fee charged plus my out of pocket maximum for my Blue cross PPO would put my out of pocket expense @ $9200 at a minimum....no F'n way I could or would swing that amount at this point in my life. After a few more seminars I have finally decided on Dr. Kelvin Higa of ALSA medical group in Fresno Ca. I did my labs and chest x-rays last Wednesday, and have my PCP appointment tomorrow @ 7:30am. I normally go to the FNP that works for the the doctor I am seeing tomorrow, but I guess he has to be the one that says I am a good candidate for bariatric surgery. My 1st appointment with Higa is on this Saturday, and my EGD is scheduled for next Wednesday. After Dr. Higa approves me as a patient I can use the Psych and Nutritionist @ Fresno Heart and Surgical free of charge. Hopefully everything is banged out before the end of January and I can get a Blue Cross approval and surgery date for the end of February.(Crossing fingers & praying) Since my PCP appointment I have had a ton of anxiety now since this is actually moving along.I'm not scared to the point of backing out(never will be either), but I feel like a 5'11 365lb 31 year old baby... I'm a worrier at heart but this is getting pretty tough. I have two little kids (5 and 2) that I'm afraid of leaving fatherless...I have faith that I will get through this ok, but it still scares the @$#% out of me. Did anybody else have this much anxiety before surgery? If so what did you do to cope with it? I really want to get my mind right for this so I don't end up being rolled into surgery crying like a big baby. I don't post much on here, but I would like to thank everybody for your stories, information and support given. It is such a great resource for people, and hopefully after I am sleeved I can become as big of a provider of help and information as the rest of you folks are.

Health food stores like GNC and even some Walmarts have protein suppliments that are clear liquid, in fruit flavors that taste like jello. Just keep trying different ones till you find something you like. I use the GNC 100% whey protein (carmel chocolate flavor) That's the only flavor I like in that brand, so even if you try one flavor in a brand and dont like it, try another. Unfortunately they should have instructed you to find one you liked before you were banded, so you wouldnt have to be going through this now one week post-op! Also I have heard that some of the bariatric web sites sell "sample" packs so you can try different products, but i dont have any specific links for that, you would have to do a search. Good luck! Get your protein....it's important.

If you are paler than before you should ask your PMD to check your hemoglobin and hematocrit along with iron studies (ferritin, etc) to be sure you aren't anemic. Are you taking iron supplements that are easily absorbable after bariatric surgery? Check with you're surgeon or nutritionist to be sure you're taking the right supplements.

I really liked Dr. Krook and the rest of the bariatric staff are wonderful too. I first started my WLS journey at Park Nicollet several years ago and it never worked out because I was never ready, and I was hesitant about going to HCMC too, but I was very pleasantly surprised by the whole staff. The main reason I went to HCMC instead of going back to Park Nicollet though was because I work for the county and the surgery was 100% paid for by my insurance.

Your bariatric report card doesn’t look so good? That might be good news: a wake-up call, with some opportunities for improvement. Back in the olden days, there was a space for teacher comments on the back of my report card. Here my teacher could write comments about areas in which I exceled or (more often) I needed to improve. Mine usually had to do with talking during class too much (except when I shut my mouth because I didn’t know the answer to a question). So, what opportunities for improvement await you this semester? Here’s an example from my own WLS journey. It was an offshoot of my New Year’s resolution, which was to log my food every day. After weeks of living that resolution, I was dissatisfied with its effect on my weight, and suddenly realized that although I’d been faithfully logging my food every day, I hadn't been paying much attention to the resulting nutritional data. In that instance, I had earned an A for effort and an F for achievement. That’s partly because I love keeping logs and journals. I can play with Excel documents 'til long after the cows come home, without any expectation of coming up with useful information. I analyze things just for the fun of analysis, so it’s far too easy for me to overlook the ways in which I might use all that stuff to improve my insight or change my behavior. So if I don’t pay attention to the data in my food log, I can’t evaluate the quality of my food intake. I’d been logging about 1400-1500 calories a day (a calorie goal that accounted for my exercise level and weight loss goal) without taking the time to notice some major inconsistencies in my macronutrients, especially protein. I need to pay attention to my protein intake not just because my body needs good-quality protein to repair the muscles I use during my daily workouts, but because low protein intake often represents maladaptive eating. Rather than slow down and eat carefully so that solid protein doesn’t cause me problems, I take the easy way out and eat the easy stuff, almost always in the form of carbs that don’t offer much satiety value, never mind nutritional value. When I was a clueless little kid, I had to rely on adults to tell me exactly how to improve my school grades, but I’m glad to report that I’m not a clueless little kid any more. I’m an occasionally clueless adult. If my realization about the quality of my food intake had never materialized, eventually I would have asked an expert, like my dietitian or doctor, for guidance. Armed with their suggestions, I would get back on the bandwagon and give that food log another honest try. And (fingers crossed) eventually earn an A for achievement!

The denial letter is a bit confusing but if I'm reading it right it was on grounds of depression and having acid reflux disease. Both thing I made clear in the beginning to the whole bariatric team that I have been seeing. I have had depression for years but it's under control with medicine. My dr did not see a reason why it would be denied.

I called Dr. Chiasson's office just this last week, because I had heard from others about the 6 month supervised diet plan also. I was not told anything about this in the beginning, so I wanted to call and make sure that I had my facts straight. Tracy (Dr. Chiasson's advocate that works with me) once again reassured me that UHC (for MY particular plan does NOT require the 6 month wait, as long as I have a letter from my PCP that I have had a 5 year documented history of morbid obesity. I have had my physicals every year, so I have no problem with that area. I (in the last 3 weeks) have gone through: 1. Labwork 2. Psychiatric visit and clearance 3. Endogastroscopy 4. 2 (yes 2 !!!) sleep studies (I was diagnosed with sleep apnea with the first visit and had to go back for another one...YUK) 5. a visit with my cardiologist (he also wants me to do a nuclear stress test next Wednesday before he will write my clearance letter. 6. a clearance letter from my PCP (with documented weight of the last 5 years) 7. and also on Wednesday, I will be meeting with the nutritionist. So Wednesday, hopefully will be all my appointments needed by UHC. I have just had to make and go to the appointments...the bariatric surgeons office has done the footwork with UHC (cause they know EXACTLY who to ask for and what to ask for). In the past years, (before I knew about VSG) I have tried on my own, and got nowhere and only frustrated to the point of giving up. I feel very fortunate that the 'digging for the criteria' has been done for me this time. I have never gotten this far before, and feel wonderfully excited. Hope this helps you, and hope that things can be easier for you...Prayers are with you.... Pat:001_rolleyes:

Hey ChiTown, I thought I'd reply to your post since I didn't get any replies to my post about UHC requirements - that has been kind of frustrating. Maybe us UHCers are not a common group here. Anyway, I have the UHC HRA plan which covers WLS as any other procedure. The main thing I had to do was initiate the process through the Bariatric Resources Center before I scheduled any appointments. If you haven't already done so, you could try calling them to see if they can help you. This is from the benefits site: Bariatric Resource Services is a program administered by UnitedHealthcare and its affiliates. For obesity surgery services to be considered Covered Health Services under the BRS program, you must contact Bariatric Resource Services and speak with a nurse consultant prior to receiving services. The member can access the BRS Service Centers of Excellence Programs at 1-888-936-7246. I would think that you could simply call the regular customer service number on your card to find out if your plan covers a specific procedure. I have never given any codes to anyone so I'm not sure why you would need to do that. I just told them that I wanted the sleeve and they verified that it was a covered procedure. I guess it depends on who you're talking to sometimes, so you might need to call the main customer service number a couple of times until you get someone who is really interested in helping you verify covered procedures. Good luck with getting everything paid for. I'm not sure what I would have done if I hadn't come to this decision and "discovered" the sleeve around the same time it became a covered procedure. I suspect I would be even deeper in debt trying to pay for it.

I do. I've had the same therapist for years now. She specializes in bariatric surgery and eating disorders. That said..im 7.5 months post op and have hit exactly the same spot as you. Suddenly feel so lost. I saw my dietician this week and I was given specific instructions to stop counting numbers. .calories/carbs/fat/protein etc. And just trust when I feel hungry. Harder to do for me than it sounds. She also told me to start going to the clinic led support group, she said I was at the point where a lot of people feel lost. This is why I think it would be great to have some sort of 6-12 month forum for us tweens as gamergirl put it on another thread. There seems to be a great deal of support for pre and fresh post op and the 1+year out vets but not us tweeners. I think thats where a lot of us fall off of here and begin to feel lost and alone.

This may have been discussed before but for anyone covered by CIGNA or one of its affiliated companies, they have abandoned their prior formal requirement of a specific duration (e.g. 3 months) in favor of this language: • A statement from a physician/physician’s assistant/nurse practitioner/registered dietician (i.e., other than the requesting surgeon) that the individual has failed previous attempts to achieve and maintain weight loss by medical management. This is the old language: • Medical management including evidence of active participation within the last 12 months in a weight-management program that is supervised either by a physician/physician’s assistant/nurse practitioner or a registered dietician for a minimum of three consecutive months ((i.e., ≥ 89 days). The weight-management program must include monthly documentation of ALL of the following components:  weight  current dietary program  physical activity (e.g., exercise program) Programs such as Weight Watchers®, Jenny Craig® and Optifast® are acceptable alternatives if done in conjunction with the supervision of a physician/physician’s assistant/nurse practitioner or registered dietician and detailed documentation of participation is available for review. However, physician-supervised programs consisting exclusively of pharmacological management are not sufficient to meet this requirement. Anyone covered by CIGNA now and going through a mandatory weight loss program under the old medical policy should request their surgeon/bariatric program to submit their request for approval NOW and not wait to finish the supervised diet. You might get some push-back from crusty bariatric practices or surgeons, but hopefully they will help you. The new policy is more favorable to patients, and because it is the medical policy in effect for anyone having surgery after October 9th, we take the position this is the operative medical policy - NOT the policy at a patient's "starting point". Call us at 1-877-992-7732 if you have questions about this or are in need of any information about what you need to do if you have been denied by your insurer - whether it is CIGNA or any other payer. Good luck to all! CIGNA medical policy effective October 9 2018.pdf